NPIMap

Organization Active NPI

Community Residences, Inc

  • Community/Behavioral Health Agency
  • Chantilly, VA
National Provider Identifier
1942218565
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY RESIDENCES, INC
Practice address
14160 Newbrook Dr Ste 100
Chantilly, VA 20151-2297
Phone
(703) 842-2327
Fax
(703) 842-2341
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terry Hurley
Title
VP Admin, Cfo
Phone
(703) 842-2321

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0904006376 VA
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

14160 Newbrook Dr Ste 100
Chantilly, VA 20151-2297

Mailing address

14160 Newbrook Dr
Chantilly, VA 20151-2297

Other identifiers 1

IdentifierTypeStateIssuer
004946707MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Community Residences Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1942218565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14160 NEWBROOK DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14160 NEWBROOK DR STE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512297",
            "telephone_number": "703-842-2327",
            "fax_number": "703-842-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESIDENCES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "VP ADMIN, CFO",
        "authorized_official_telephone_number": "703-842-2321"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006376",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004946707",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.